Autoimmune disorders involving the connective tissue have complex pathogenetic origins and diverse clinical manifestations. Systemic sclerosis (or scleroderma) has the highest cause specific mortality of all of the connective tissue diseases, and the majority of patients with systemic sclerosis suffer from serious gastrointestinal tract symptoms. While the cause of gastrointestinal tract dysfunction in systemic sclerosis is unknown, Dr. Elizabeth Volkmann, a Rheumatologist at UCLA who specializes in the care of patients with systemic sclerosis, has recently teamed up with Dr. Jonathan Braun, Chair of Pathology and Laboratory Medicine, to discover whether patients with systemic sclerosis have alterations in their intestinal microbiota.
 

Current Research Projects

Working with a team of gastroenterologists at UCLA, which includes Dr. Bennett Roth, Dr. Terri Getzug and Dr. Jeffrey Conklin, the UCLA Scleroderma Microbiome Initiative, also seeks to determine whether certain microbial species contribute to the gastrointestinal phenotype in systemic sclerosis. Dr. Volkmann’s group has recently demonstrated that patients with systemic sclerosis have increased pathobiont (invasive, pro-inflammatory) microbial genera and decreased commensal (normal, healthy) microbial genera compared with healthy control patients. In addition, this group found that systemic sclerosis patients with lower levels of Bacteroides fragilis (a commensal bacterial species) had more severe gastrointestinal symptoms compared with patients with higher levels of this species. The UCLA Scleroderma Microbiome Initiative continues to explore the intricate interactions among the microbiome, metabolome, and proteome in systemic sclerosis, with the hopes of identifying novel therapeutic targets for this devastating autoimmune condition.
 

Recent News

Unique Microbial Signature Identified in Systemic Sclerosis
Medscape (June 12, 2015)

First gut microbiota alterations described in systemic sclerosis patients
PM360 (June 11, 2015)
 

Key People

Photo of Elizabeth Volkmann, MD, MS
Elizabeth Volkmann, MD, MS
Clinical Instructor, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine at UCLA

Dr. Elizabeth Volkmann is a Clinical instructor in the Department of Medicine, Division of Rheumatology at UCLA. She is the Founder and Director of the Connective Tissue Disease-Interstitial Lung Disease (CTD-ILD) Integrative Clinic Program at UCLA. She received her medical degree from UCLA David Geffen School of Medicine, and subsequently completed her residency in Internal Medicine and fellowships in Rheumatology and Medical Education at UCLA. During her fellowship, she participated in the Specialty Training and Advanced Research (STAR) Program and earned her Master of Science degree in Clinical Research.

Her clinical and research expertise is in systemic sclerosis (scleroderma), a rare and disabling autoimmune disease that affects gastrointestinal function in the majority of patients. She is currently the principal investigator of an innovative study to characterize the gastrointestinal tract microbiome in patients with systemic sclerosis. This study aims to investigate the hypothesis that the systemic sclerosis disease state is associated with altered colonic microbial composition at the human mucosal-luminal interface, and to determine whether certain microbial genera contribute to symptoms of gastrointestinal tract dysfunction in patients with systemic sclerosis. If affirmed, such genera could provide specific targets for intervention to avert or treat this important clinical dimension of systemic sclerosis.

Recent Relevant Publications/Presentations:

  1. Volkmann ER, Chang, Y-L, Barroso N, et al. Systemic sclerosis is associated with a unique colonic microbial consortium. Annals Rheumatic Diseases 2015;74:151.
  2. Volkmann ER. Systemic sclerosis is associated with a unique colonic microbial consortium. Oral Presentation at the European League Against Rheumatism Annual Congress, 2015. Rome, Italy.

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